PHILOSOPHY

Let’s imagine a common situation which illustrates the approach we work with. In many countries in the world it is forbidden to drive over a certain speed limit. Let’s imagine that a driver exceeds this legal limit, loses control of his vehicle and has an accident. As a result of the accident he fractures both legs and is taken to hospital. During the examination, the doctor finds out that the accident has been caused by an excess in speed. Given that excess speed is illegal and is forbidden, the doctor decides that the patient is responsible for the accident and should pay the consequences of his illegal behaviour. So he discharges him from hospital and sends him home with some painkillers and anti-inflammatories. As a general rule, people would accept that, in this situation, the doctor should be sued for bad professional practice. It seems clear that a specialist should never judge their patient, but instead they are obliged to give the best available treatment in any situation.

Let’s continue with our example. The aforementioned doctor understands the nature of bones, but considers that rest and taking painkillers should be enough to cure the patient. He does not take into account the pain and discomfort of the injured person, since he considers this will only last a couple of weeks. For him the only difficult part of the treatment is to get the patient’s legs to recover their functions. He knows that the patient will probably try to avoid doing the painful exercises needed to rehabilitate his legs and will even try to cheat his family or carers so as not to do them. We can assume that in these conditions it is improbable that the bones will cure adequately, and that any attempt at rehabilitation will be useless. The patient will probably complain about the pain and will not follow the advice of the doctor with regards to rehabilitation. The doctor can then consider that the patient does not want to be cured, as he is not willing to take part in the rehabilitation (instead of considering that the treatment programme is inadequate). Current knowledge indicates that the use of drugs damages essential mechanisms in the brain, such as receptors and neurotransmitters (“the bones”). If they are not treated properly, using a complete and individualized treatment programme (instead of the indiscriminate prescription of tranquillizers), it very improbable that the patient’s receptors and neurotransmitters will recover and that they will be able to follow a rehabilitation programme in a satisfactory way.

The facts mentioned are fundamental for our research programmes. For example, in 1996 research on the success of our treatment programme revealed that almost 5% of patients abandoned the treatment after leaving the hospital, before initiating the rehabilitation programme. Instead of holding the patient responsible or considering their illness chronic, we look for the reasons behind this failure to continue with the treatment. We discovered that the main cause of the problem was in the reduction of certain cerebral electrolytes and neurotransmitters like serotonin. We introduced this change in our programme and congratulate ourselves on the fact that at the present time the relapse rate in our patients at that stage of treatment is less than 1%.